ADHD Clinical Trial
Official title:
TEAMS (Training Executive, Attention, and Motor Skills): - Intervention Program for Preschoolers With ADHD (Attention Deficit Hyperactivity Disorder). A Rct. Proof-of-Concept Study.
Background:
TEAMS (Training Executive Attention and Motor Skills) is a non-pharmacological,
neurocognitive intervention program targeted preschool children with ADHD developed by
Professor Jeffrey Halperin, and his team from New York University. The uniqueness of this
program lies in the concept, based on stimulating neurocognitive growth through focused
physical activity and play (Halperin et al.; 2011, 2012, in press).
Teams hypotheses:
TEAMS is based on the notions that:
1. The behavioural manifestations of ADHD are the result of deficient neural networks that
affect a wide array of neurocognitive and behavioural processes which are not
necessarily identical in all children with the disorder.
2. Neurodevelopment is sensitive to and can be positively affected by appropriate
environmental influences.
3. Effective environmental stimulation will be best achieved within a social context.
4. The engagement of the child in the core activities of the treatment must be
intrinsically rewarding (i.e., fun) in order to facilitate compliance of the
intervention.
The initial research by Halperin et al. (2012)indicated significant improvement in ADHD
severity from pre- to post-treatment, which also persisted 3 months later.
Objective: The aim of this study is, through a randomized controlled trial (RCT), to
validate the TEAMS treatment program in a clinical setting in Denmark.
Method: Pre-school children age 3-6, from Region Zealand in Denmark, diagnosed with ADHD as
primary diagnosis are offered participation in the RCT study of the TEAMS program. The
control groups receive the standard treatment program, outlined by the clinical guidelines
of Region Zealand. The intervention groups participate in eight weekly group sessions
consisting of separate parent- and children's groups.
In the child group the children are introduced to games that are designed to enhance
inhibitory control, working memory, attention, visuospatial abilities, planning, and motor
skills. The parent group consists of psychoeducation and instructions in how to encourage
playing these games with their children and how to support the child's development.
Based on a calculation of strength:
Concurring to a statistically significant outcome the estimated cohort should be minimum 87
children. Based on Region Zealand's visitation history records the cohort is expected to be
approximately 100-160 children.
Group size:
The number of participants in each treatment group depends in part on how many children have
been recruited. Given the constraints of our setting, treatment groups generally consist of
at least two, and up to five participants.
Staffing: Two group leaders and one student-assistant are present for every five
participants in the playgroup.
For the primary efficiency measurements the project uses: ADHD-RS-IV (Attention Deficit
Hyperactivity Disorder Rating Scale fourth edition), a scale for evaluating the severity of
the ADHD symptoms, SDQ-DAN (Strengths and Difficulties Questionnaire - Danish translation)
focuses upon the child's strengths and weaknesses in accordance with activity and attention,
emotional problems, behavioural difficulties etc. For the secondary efficiency measurements
the project uses: TCA (Treatment Compliance Assessment) (Halperin et al: in press), which
establishes how much time the child spends on each TEAMS activity and television/computer
games each day. Each day the parents fill out the TCA, as part of a logbook which also
describes compliance with the TEAMS treatment project.
The questionnaires are continuously catalogued in a database facility (SurveyXact).
The TCA instrument is completed weekly during the 8 week TEAMS program.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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